Individual provider Active NPI

Caroly Lucy Guillen Aguirre, MD

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1104566553
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0103670 Issued in MD
Practice address
12107 Old Line Ctr
Waldorf, MD 20602-2552
Phone
(240) 207-6450
NPI assigned
Mar 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0103670 MD Primary

Addresses

Primary practice location

12107 Old Line Ctr
Waldorf, MD 20602-2552

Mailing address

8250 Westpark Dr Apt 570
MC Lean, VA 22102-3178
Phone (703) 505-2563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406003279 MD Practitioner - Internal Medicine 8921573171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12107 Old Line Ctr
Waldorf, MD 20602-2552
Phone (855) 830-8346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0103670MDMDInternal Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1104566553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8250 WESTPARK DR APT 570",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023178",
            "telephone_number": "703-505-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12107 OLD LINE CTR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022552",
            "telephone_number": "240-207-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEN AGUIRRE",
        "first_name": "CAROLY",
        "middle_name": "LUCY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0103670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.